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Journal of Occupational Health Jan 2024To compare the effects of 1-hour computer use on ulnar and median nerve conduction velocity and muscle activity in office workers with symptomatic neck pain and...
OBJECTIVES
To compare the effects of 1-hour computer use on ulnar and median nerve conduction velocity and muscle activity in office workers with symptomatic neck pain and asymptomatic office workers.
METHODS
A total of 40 participants, both male and female office workers, with symptomatic neck pain (n = 20) and asymptomatic (n = 20), were recruited. Pain intensity, ulnar nerve conduction velocity, median nerve conduction velocity, and muscle activity were determined before and after 1 hour of computer use.
RESULTS
There was a significant increase in pain intensity in the neck area in both groups (P < .001). The symptomatic neck pain group revealed a significant decrease in the sensory nerve conduction velocity of the ulnar nerve (P = .008), whereas there was no difference in the median nerve conduction velocity (P > .05). Comparing before and after computer use, the symptomatic neck pain group had less activity of the semispinalis muscles and higher activity of the anterior scalene muscle than the asymptomatic group (P < .05). The trapezius and wrist extensor muscles showed no significant differences in either group (P > .05).
CONCLUSIONS
This study found signs of neuromuscular deficit of the ulnar nerve, semispinalis muscle, and anterior scalene muscle after 1 hour of computer use among office workers with symptomatic neck pain, which may indicate the risk of neuromuscular impairment of the upper extremities. The recommendation of resting, and encouraging function and flexibility of the neuromuscular system after 1 hour of computer use should be considered.
Topics: Humans; Male; Female; Adult; Ulnar Nerve; Neural Conduction; Median Nerve; Neck Pain; Occupational Diseases; Electromyography; Computers; Middle Aged; Muscle, Skeletal; Time Factors
PubMed: 38710168
DOI: 10.1093/joccuh/uiae023 -
Folia Morphologica 2023Variations of the nerves of the forearm can lead to unexpected clinical findings during physical examination. Additionally, surgery in this region might encounter and...
Variations of the nerves of the forearm can lead to unexpected clinical findings during physical examination. Additionally, surgery in this region might encounter and potentially damage the nerve in such patients. Here, we present a case of a high split of the median nerve and discuss the findings of the case as well as review salient reports in the literature. Knowledge of such a variation can be important in patient diagnosis and treatment.
Topics: Humans; Median Nerve; Forearm
PubMed: 34845718
DOI: 10.5603/FM.a2021.0129 -
Clinical Biomechanics (Bristol, Avon) Jan 2020Carpal tunnel and median nerve dynamically change with wrist motion. The purpose of this study was to investigate the morphological changes and positional migration of...
BACKGROUND
Carpal tunnel and median nerve dynamically change with wrist motion. The purpose of this study was to investigate the morphological changes and positional migration of the carpal arch and median nerve, as well as nerve-arch positional relationship associated with wrist deviation in healthy volunteers.
METHODS
Twenty asymptomatic male volunteers performed wrist motion from neutral to deviated positions combining flexion-extension and radioulnar deviation. Ultrasound images of the carpal arch and median nerve at the distal carpal tunnel were collected during wrist motion. Morphological and positional parameters of the carpal arch and median nerve were derived from the ultrasound images.
FINDINGS
Carpal arch height, area, and palmar bowing of the transverse carpal ligament (TCL) increased with flexion related wrist motion and decreased with extension related motion (P < 0.05). Arch width increased with radial flexion and decreased with extension and ulnar extension (P < 0.05). Median nerve circularity increased with flexion and radial flexion but decreased with extension, ulnar extension, and ulnar deviation (P < 0.05). Nerve centroid displaced ulnarly with radial deviation, radial flexion, and radial extension and displaced radially with ulnar deviation, ulnar flexion, and ulnar extension (P < 0.05). Nerve centroid displaced in the dorsal direction with flexion and radial flexion, but in the palmar direction with extension (P < 0.05). Nerve-TCL distance increased with flexion related motion and decreased with extension relation motion (P < 0.05).
INTERPRETATION
The current study advances our understanding the effect of wrist motion on the carpal tunnel and its contents, which has implications for pathomorphological and pathokinematic changes associated with wrist disorders.
Topics: Adult; Carpal Bones; Female; Healthy Volunteers; Humans; Ligaments, Articular; Male; Median Nerve; Motion; Radius; Range of Motion, Articular; Ultrasonography; Wrist; Wrist Joint
PubMed: 31733628
DOI: 10.1016/j.clinbiomech.2019.10.024 -
JPMA. the Journal of the Pakistan... Aug 2022To determine median nerve tightness in smartphone users, and to compare the upper limb functions between those with and without median nerve tightness. (Observational Study)
Observational Study
OBJECTIVE
To determine median nerve tightness in smartphone users, and to compare the upper limb functions between those with and without median nerve tightness.
METHODS
The cross-sectional, observational study was conducted at the Institute of Physical Medicine and Rehabilitation, Dow University of Health Sciences, Karachi, from March 2020 to January 2021, and comprised subjects of either gender aged 20-40 years who had been using smartphone for >1 year. Body mass index was calculated. The participants were evaluated using upper extremity functional index-15. A hand-held dynamometer was used to assess handgrip strength, and a pinch meter assessed the pinch strength. Manual upper limb tension test 1 was used for median nerve tightness. Frequencies and percentages were drawn for all categorical variables. Data was analysed using SPSS 22.
RESULTS
Of the 277 subjects, 198(71.5%) were females. The largest group 176(63.5%) was aged 21-25 years. The mean upper limb functional index was 84.24±15.09. Also, 113(40.8%) subjects were positive for left-side median nerve tightness and 122(44%) were positive on the right side. There was no significant association between median nerve tightness and upper extremity function (p>0.05). The association, however, was significant with the duration of mobile usage in years (p<0.05).
CONCLUSION
Prolonged overuse of smartphone may lead to symptoms of median nerve tightness, but it was not found to have an effect on upper limb function, handgrip and pinch strength.
Topics: Female; Humans; Male; Hand Strength; Median Nerve; Cross-Sectional Studies; Smartphone; Universities; Public Sector; Upper Extremity
PubMed: 36280914
DOI: 10.47391/JPMA.3824 -
Ultrasound in Medicine & Biology Nov 2019Nerve movement is decreased in patients with carpal tunnel syndrome and can be assessed with ultrasound. In addition to morphologic features, this study describes a...
Nerve movement is decreased in patients with carpal tunnel syndrome and can be assessed with ultrasound. In addition to morphologic features, this study describes a novel approach in which nerve movement and the association with short-term patient-reported outcome are assessed. Ultrasound images at the carpal tunnel inlet were acquired during finger and wrist flexion. Linear regression models were used with the Boston Carpal Tunnel Questionnaire as main outcome. Eighty-five patients were included; 93% completed the 3-mo follow-up. Pre-surgical mean nerve area was 14.5 ± 4.2 mm and decreased to 13.3 ± 3.8 mm (p < 0.001). Displacement in dorsal direction with wrist flexion increased from 1.9 ± 1.3 to 2.4 ± 1.3 mm (p < 0.01). A pre-surgical larger nerve area was associated with more functional improvement (β = -0.024, p = 0.02), but baseline mobility was not. Change in excursion with finger flexion was associated with symptomatic improvement, but with a small effect (β = -0.05, p = 0.01). This indicates that there is limited prognostic potential for dynamic transverse ultrasound in carpal tunnel syndrome.
Topics: Adult; Aged; Aged, 80 and over; Carpal Tunnel Syndrome; Female; Humans; Male; Median Nerve; Middle Aged; Prognosis; Prospective Studies; Surveys and Questionnaires; Ultrasonography
PubMed: 31488311
DOI: 10.1016/j.ultrasmedbio.2019.06.422 -
Intensive Care Medicine Jun 2023
Topics: Humans; Consciousness; Median Nerve; Glasgow Coma Scale
PubMed: 37210686
DOI: 10.1007/s00134-023-07097-6 -
Journal of Neural Engineering Jul 2022. Accurate identification of functional cortical regions is essential in neurological resection. The central sulcus (CS) is an important landmark that delineates...
. Accurate identification of functional cortical regions is essential in neurological resection. The central sulcus (CS) is an important landmark that delineates functional cortical regions. Median nerve stimulation (MNS) is a standard procedure to identify the position of the CS intraoperatively. In this paper, we introduce an automated procedure that uses MNS to rapidly localize the CS and create functional somatotopic maps.. We recorded electrocorticographic signals from 13 patients who underwent MNS in the course of an awake craniotomy. We analyzed these signals to develop an automated procedure that determines the location of the CS and that also produces functional somatotopic maps.. The comparison between our automated method and visual inspection performed by the neurosurgeon shows that our procedure has a high sensitivity (89%) in identifying the CS. Further, we found substantial concordance between the functional somatotopic maps generated by our method and passive functional mapping (92% sensitivity).. Our automated MNS-based method can rapidly localize the CS and create functional somatotopic maps without imposing additional burden on the clinical procedure. With additional development and validation, our method may lead to a diagnostic tool that guides neurosurgeons and reduces postoperative morbidity in patients undergoing resective brain surgery.
Topics: Brain Mapping; Cerebral Cortex; Craniotomy; Electrocorticography; Humans; Median Nerve
PubMed: 35785769
DOI: 10.1088/1741-2552/ac7dfd -
BMC Musculoskeletal Disorders Jan 2020The objective of this study is to investigate the prognostic values of median nerve strain and applied pressure measurement for the assessment of clinical recovery after...
BAKGROUND
The objective of this study is to investigate the prognostic values of median nerve strain and applied pressure measurement for the assessment of clinical recovery after carpal tunnel release.
METHODS
Forty-five wrists, from 45 idiopathic carpal tunnel syndrome patients who treated with open carpal tunnel release, were evaluated by ultrasound. Median nerve strain, pressure applied to the skin, and ratio of pressure-strain were measured at the proximal part of the carpal tunnel. In addition, distal latencies in the motor and sensory nerve conductions studies and cross-sectional area of median nerve were measured. The parameters were compared before and after the open carpal tunnel release. According to patient recovery, the receiver operating characteristic curves were generated to evaluate the prognostic values of the parameters. The areas under the receiver operating characteristic curves were compared among parameters.
RESULTS
There was a significant increase in the median nerve strain, and significant decreases in the pressure applied to the skin and ratio of pressure-strain after carpal tunnel release (P < 0.01). There were significant decreases in the distal latencies and the cross-sectional area after carpal tunnel release (P < 0.01). The areas under the curves were 0.689, 0.773, 0.811, 0.668, 0.637, and 0.562 for the pressure, strain, pressure-strain ratio, motor latency, sensory latency, and area, respectively.
CONCLUSIONS
The results suggest that elasticity of the median nerve and pressure around the nerve recover quickly after carpal tunnel release. Pressure-strain ratio was the most reliable parameter to reflect clinical recovery. The measurement of strain and applied pressure can be useful indicators to evaluate effectiveness of the carpal tunnel release.
TRIAL REGISTRATION
Registered as NCT04027998 at ClinicalTrials.gov. Retrospectively registered on July 22, 2019.
Topics: Adult; Aged; Aged, 80 and over; Carpal Tunnel Syndrome; Case-Control Studies; Elasticity Imaging Techniques; Female; Humans; Male; Median Nerve; Middle Aged; Orthopedic Procedures
PubMed: 31926552
DOI: 10.1186/s12891-019-3033-y -
Carpal Tunnel Syndrome Treatment and the Subsequent Alterations in Median Nerve Transverse Mobility.Journal of Ultrasound in Medicine :... Aug 2021The mobility (transverse movement) of the median nerve (MN) is decreased in patients with carpal tunnel syndrome and can be measured noninvasively by ultrasound. To...
OBJECTIVES
The mobility (transverse movement) of the median nerve (MN) is decreased in patients with carpal tunnel syndrome and can be measured noninvasively by ultrasound. To date, there are few prognostic features to help predict the outcome of 2 commonly performed treatments: surgical carpal tunnel release and corticosteroid injection. This study aimed to assess the changes in nerve mobility after the intervention and to correlate this with treatment and the disease severity.
METHODS
A total of 181 patients with carpal tunnel syndrome with different electrophysiologic severities were recruited and assessed by dynamic ultrasound scanning of the MN before and after treatment. The dynamic ultrasound images were collected while the patients performed finger and wrist flexion.
RESULTS
For both injection and carpal tunnel release, the nerve displacement increased with wrist flexion, from a mean ± SD of 7.0 ± 2.4 to 7.9 ± 2.7 mm (P < .005). Patients who underwent surgery showed greater improvement (P < .005) in nerve mobility compared to those who underwent injection. We also observed that the increase in nerve mobility was predominantly in patients with more nerve damage at baseline.
CONCLUSIONS
This study shows that the dynamic behavior of the MN changes in response to treatment and lays a foundation for future studies to assess the prognostic potential of nerve mobility measurement.
Topics: Carpal Tunnel Syndrome; Humans; Median Nerve; Ultrasonography; Wrist; Wrist Joint
PubMed: 33073880
DOI: 10.1002/jum.15535 -
Hand (New York, N.Y.) May 2021Endoscopic carpal tunnel release (ECTR) has purported advantages over open release such as reduced intraoperative dissection and trauma and more rapid recovery....
Endoscopic carpal tunnel release (ECTR) has purported advantages over open release such as reduced intraoperative dissection and trauma and more rapid recovery. Endoscopic carpal tunnel release has been shown to have comparable outcomes to open release, but open release is considered easier and safer to perform. Previous studies have demonstrated an increase in carpal tunnel volume, regardless of the technique used. However, the mechanism by which this volumetric increase occurs has been debated. Our study will determine through magnetic resonance imaging (MRI) analysis the morphologic changes that occur in both open carpal tunnel release (OCTR) and ECTR, thereby clarifying any morphologic differences that occur as a result of the 2 operative techniques. We hypothesize that there will be no morphologic differences between the 2 techniques. This was a prospective study to compare the postoperative anatomy of both techniques with MRI. Nineteen patients with clinical and nerve conduction study-confirmed carpal tunnel syndrome underwent either open or endoscopic release. Magnetic resonance imaging was performed preoperatively and 6 months postoperatively in all patients to examine the volume of the carpal tunnel, transverse distance, anteroposterior (AP) distance, divergence of tendons, and Guyon's canal transverse and AP distance. There was no significant difference in the postoperative morphology of the carpal tunnel and median nerve between OCTR and ECTR at 6-month follow-up on MRI. We conclude that there are no morphologic differences in OCTR and ECTR. It is an increase in the AP dimension that appears to be responsible for the increase in the volume of the carpal tunnel.
Topics: Carpal Tunnel Syndrome; Endoscopy; Humans; Median Nerve; Neurosurgical Procedures; Prospective Studies
PubMed: 31331208
DOI: 10.1177/1558944719861711